Commentary: High on Ebola, low on chikungunya

by D.R. Miller

Since the recent outbreak of chikungunya in the Caribbean, four people with close connections who arrived back to into the US from the Caribbean region were hospitalized immediately and diagnosed with the virus. In addition, a few medical center employees communicated that they have seen an increase of patients from the region admitted to their medical facilities.

I am not a medical doctor, nor I do I play one on the television; however, based on the recent reports chikungunya has seen a significant up-tick. On the other hand, an impression is being portrayed that it is under control on these shores. What  long term-effect it has on people  is not  known at this time.

The leaders must address this issue openly and develop a solid plan before this potential storm, where soon US and other well-traveled countries by the Caribbean people will begin to put the medical drone in the region.

The drone concept is geared to destroy anything in its path when launched. However, could you blame the US if they cut travel, and begin to set a high alert and other screening of passengers from the region?

The recent death of Thomas Duncan from Ebola at age 42, who arrived in the US, has created an intensive focus on foreign travelers from many poor and developing countries.

Although many believed Thomas Duncan’s death while in US care would inevitably send a statement to others to not come, many people are now wondering what the color of medicine is after two dedicated Caucasian doctors who worked in Liberia contracted the virus and recovered.

One of the silent tones in the Caribbean addressing chikungunya, I believe, is not the politics of the virus, which is often seen elsewhere, for the region it is all economics.

Here is why: Most of the region’s economic engine is tourism, and if any indication like what has been taken place in Liberia, it could be worse than the economic collapse in 2008 that left many still sneezing

I begin to wonder if this is a reason reports of this increasing tide seem a bit hushed up to protect the tourism industry while many locals are suffering silently. Any business model during a turbulent time is not only to ready, but willing to tell about structural problems. This approach not only builds credibility, but also shows a level of leadership that is lacking today on several fronts.

This is not a call for a reduction of travel to and from the region, or high-level screening at airports — that would be premature at this point. On the other hand, when the local government is slow to educate people, this could be a tornado building. Therefore, questions must be asked. Along these blue waters there lies an undercurrent overflowing its banks at any time, and the long-term impact could cripple many lives, both medically and economically.

Managing these issues takes compassion and resources. Recently I saw a Facebook picture post of what appeared to be a sick person from the region who became more victimized as he was scorned from an appearance of what is believed to be the symptoms of the Ebola virus. Furthermore, when it is reported that few local doctors are contemplating refusing to report to work in the event of an outbreak due to the lack of medical supplies and other resources that is troubling.

In today’s society, where billions are being spent on wars and politicians re-election, it is hard to fathom that lack of resource and awareness, combined with scorn, can leave many more suffering. I hope elective officials, medical staff, and CARICOM step up its mandate to educate people and seek help through awareness, because the potential problems such as what is occurring in Liberia and other West African countries, where perception is more dangerous that an actual virus.

These islands are unique and sometimes that can be their own downfall because the uniqueness creates a form of isolation. It further limits collaboration, as all seem to be competing for piece of the visitors pie. Therefore, competition mutes concerns, while marketing becomes“them and not us mentality.”

This virus is not just an island thing, or in Third World countries as one of my less informed friends stated, he is going to stop eat chicken, and stop going to places where lots of chicken are found.

Education is key: No, you cannot get it from eating chicken, or visiting places where chicken are in abundance. The name chikungunya derives from a word in Makonde language roughly meaning that which bends up reflecting the physique of a person disabled by the disease. Many reports have noted that it was first identified in Tanganyika (now Tanzania) in 1952

According to the Pan American Health Organization (PAHO), the first known autochthonous chikungunya cases in the Western Hemisphere occurred in October 2013 on the island of Saint Martin. By March 2014, travelers to other Caribbean islands carried it to: Dominica; the British territories Anguilla and British Virgin Islands; overseas departments of France — Guadeloupe, Martinique; and the constituent countries of the Netherlands Antilles, as well as other areas such as St Kitts and Nevis; the Dominican Republic; and St Vincent and the Grenadines.

An estimated 3.6 billion persons in 124 countries are at risk worldwide, such as the many who are exposed to dengue fever. Large outbreaks have also been seen Indian Ocean islands, India and South-East Asia, according to the Infection, Genetic, and Evolution Journal. It has also reached Asia and Europe, and North America has seen a few cases recently in Florida.

The National Institute of Health, World Health Organization, Public Health Department, and Infectious Disease, noted that chikungunya is a viral disease that is rarely fatal. It is transmitted to humans by infected mosquitoes.

The symptoms include high fever and headache with debilitating joint pains, swelling and stiffness of joints, muscular pain, headache, fatigue, nausea, vomiting, and rash that can last for several weeks. Normally within four to seven days as reported after been bitten, the symptoms appear.

The mosquitoes become infected when they feed on an infected person during the viraemic period. Today, there are no specific antiviral treatments or vaccines available. However, it also has been reported that commonly used medications include ibuprofen, naproxen, acetaminophen, paracetamol, and aspirin.

Although there have been reported deaths, the number of related deaths are extremely low compared to Ebola; however, one should not discount it as a storm that will pass soon.

These regions have to debunk that only certain medicine can cure this outbreak, while many studies have reported there are no known cures at this time for the symptoms. It is extremely important that people take serious preventive measures such as bite-proof long sleeves and trousers. 

Purchasing  untested drugs in desperation from local street vendors might not be the best approach, especially for people with limited or no access to healthcare.  More information can be found published by many health organizations.

It can be extremely difficult to track down all mosquitoes and apply chemical spray on an entire region to cut concerns and especially in poor  and, rural areas with pool of slow-flowing water that is a breeding ground for mosquitoes and the lack of access to good health care only add to the problem.

Today many travelers are still waiting on a concrete government plan on how they are handling the issue in a coördinated effort. If there is one, please post.

Although some awareness has been posted, and the governments seem now to be taking steps to mitigate the potential problem, more needs to be done. Nevertheless, can we all be stratified?

This is not to reduce  any attempts, as the lack of resources can make this a difficult task. Moreover, the chance of being robbed, shot or killed in some of these areas, is more than likely than contracting the virus.

As the region continues to attract visitors, it is also important that these visitors receive a disclaimer of this undercurrent taking place.

The leaders must make sure that all proactive measures are taken, and seek help and resources as needed, and stop putting on a good face on this issues with a relaxed attitude.

I am still optimistic that all can come together and weather the storm. Moms and I have a ticket ready to land soon to take a break from the upcoming winter.

Commentary: A new look at violence against women

By D.R. Miller

here are several definitions of domestic violence. Here is the simplest one: “If it feels wrong, it is.”

One legal definition of domestic violence: It consists of acts committed in the context of an adult intimate relationship. It is a continuance of aggressive and controlling behaviors, including physical, sexual, emotional and psychological attacks, that one intimate partner does to another

Since the 1980, many policies have been amended and have given women constitutional rights to safety and equally protection, but the struggle continues. One of the problems is that it is often seen and described as the tolerant cultural traits and a taboo, where guilt and shame makes it difficult for victims to come forward.

What is the color of domestic violence? Often the media only cover domestic violence when a rich and famous person is abused, arrested or killed. What has happened to poor individuals’ cases? Domestic violence seems to be green. Today, thanks to cameras, tapes are bringing all faces of victims and perpetrators of domestic violence from behind closed doors.

September 8, 2014, reminded us that domestic violence is still a cancer when the Ray Rice, a National Football League (NFL) player, video came out. We saw his fiancée knocked out unconscious in an elevator and being dragged out like a piece of luggage.

Within hours, the OJ Simpson 1995 double murder case in which he was acquitted emerged on almost every news lead-in. This was not co-incidental; OJ’s name generates ratings and a platform that often divides. Most importantly, his case has created more awareness calls to domestic violence centers since.

Despite the media’s recent highlight on almost every black NFL player, there are other Ray Rices still in many games, in schools, mosques, synagogues, churches, and co-workers in disguise. I am not minimizing his behavior. He should be punished both in the court of law and in his career.

Violence should not be broadcast to further polarize a society. Should we now keep scorecards of offenders to balance the portrayal of certain groups? Should we go to the archives and pull up Scott Peterson, who also killed his seven-and-a-half months pregnant wife with her only child when OJ’s name is mentioned?

Four years earlier, Pittsburgh Stealers quarterback, Ben Roethlisberger, was accused of three rape charges. The district attorney later dropped the charges.

It was reported that alcohol played a role. Ray Rice also stated that he was intoxicated. Furthermore, can society add South Africa’s Oscar Pistorius, the disabled track star who killed his girlfriend?

For victims, an assault is simply that. It is not them vs us. This divide does not give hope and needs to be debunked.

The Reality: Violence against women is not a new paradigm shift. I am afraid many experts and pundits will move-on soon, and so does domestic violence as it returns behind closed doors until another funeral.

We all know someone and or saw an abuse and asked ourselves why? “He was a nice person and she seemed fine.” This is simple another subconscious minimization process.

In these relationships the “power and control wheel have been active: (1) male privilege; (2) economic abuse; (3) emotional; (4) isolation; and (5) minimization.”

Today, tackling domestic violence is troubling, as stratification has created a polarized and intolerant society where socio-economic inequality, haves vs have-nots forced domestic violence into political debates. Soon it will be polled for a comprehensive policy to pass Congress and other legislative bodies to protect women.

In addition, giving few people airtime as the good ones does not tell the full story.

Many studies have shown that the homicide and victimization rates for black men and women are higher than the national average. These pundits only offer a temporarily feel-good segment because one mug-shot is not plastered on the screen.

Directly or indirectly, violence is a community problem such as Boko Haram’s  ideology when some believe it is only a Nigerian problem. This ideology is in the Caribbean, the USA, and other countries in disguise.

Domestic violence must taken with a sense of urgency worldwide such as dismantling ISIS, Ebola or any terrorist organization. Although one cannot order a drone strike on an abusive husband, law enforcement, policies and support have to be able to track and dismantle these abusers and give help as needed.

In the 1980s, the US Mothers Against Drunk Driving (MADD) organization played a pivotal role in a grass-roots movement that rewrote laws and battled cultural resignation about alcohol-related traffic deaths. The same has also taken place with gun-advocates. More groups needs to be formed world wide.

Who are the faces of violence?

Domestic violence affects young, old, blacks, whites, rich, poor, gay, straight, Christians or non-believers. Furthermore, not having black eye should not discount one as a victim.

Many of these women stayed in these abusive relationships for economic survival and their children’s safety. Men also get abused but statistics shows more men abuse women.

The Data: According to the Washington Coalition Against Violence, including other studies, at least one in every three women has been beaten, coerced into sex or otherwise abused during her lifetime

These abusers are members of her own family. One in six women and one in 33 men experienced an attempted rape

The amount of children witnessing violence is over 80 million and nearly one in five teenage girls have been in a relationship where a boyfriend threatened violence or self-harm if presented with a breakup. It is one of the leading causes of injury to women — more than car accidents, muggings, and rapes combined

In the US alone, a husband or boyfriend murders more than three women each day and every nine seconds a woman is assaulted or beaten.

This is not only a psychological nightmare for families and friends; the economic toll is extremely high. An estimated $4.1 to $5.8 billion resulted from victims who lose days of work alone, which is about 32,000 full-time jobs.

In 70-80% of these cases, the men psychically abused the woman before the murder. Domestic violence cases comprise of more than half of police response calls, more than robbery, motor vehicle theft, burglary as reported. The long-term medical impact for treatment combined with the stigma is harmful.

In most cases, domestic and sexual violence are not closely occurring at the same time.

Need for universal policies coast to coast: If all crimes become a community health problem, and the no drop clause is implanted, where a victim has no control over the prosecution and it is seen as it is — a criminal act — more can be done immediately.

Why: It was late one Sunday night; I’d just gotten back from a long flight after visiting the region. The telephone rang and a sad voice emerged. The first thought was to say, “How did you gain access to my telephone number?” I later learned a friend of a friend or a friend provided my telephone number.

According to the victim, a criminal complaint had already been filed against her abusive husband. There was minimal sign that physical abuse had taken place, and about her third call for help.

This time a doctor’s report was needed to make an arrest and she had to head back home to wait. The local doctor had to be paid in advance by the victim before such medical exam could be completed for a recommendation for an arrest to take place.

Few years later, I still wonder what if the police department was led by a woman with the resources and a responsive system, how different her life would be today? How many died waiting? Imagine being abused and an arrest hung on a medical assessment where the fees are more important.

Treatment Modality: The law does not have to be mandatory prosecution on all cases, but an immediate intervention. Furthermore, simple relying on only physical evidence makes it less likely one more will be killed, and continue to be victimized.

A swift adjudication process is key, and treat all incidents as a criminal act, and make sure victims are empowered.

Domestic violence is not just a few of weeks of treatment sessions where the offender minimizes and refuses to take responsibility and only shows up because he has been caught. Especially in the poor regions, offenders must be held accountable. Outdated laws needs to be amended to send a clear message from the high school to the work place that this kind of behavior must be met with stiff penalties.

Change an old  male chauvinist ideology where women are defined by how high her heels are and not by their work. Both sides should work together and call out violence before it becomes another Rest in Peace obituary.

Developing and promoting more women into key leadership roles will not cut violence against women overnight, but decisions that affect women will have a seat at the table.

Laws are the first line of defense, and priority must be given to victims. The outdated ideology, “She deserved it”, has to stop, especially in poor communities where the rich and powerful often muzzle the outcome of prosecutions.

If this cycle continues, it only creates a new generation that will marry someone who is either abusive or becomes an abuser themselves.

Refocus: Leaders must invest in young women who are consistently overlooked and treated as second-class citizens. Even when one is qualified, the glass ceiling remains active. As a society, all must move from this first view on the surface.

This mentality is one of a laundry detergent, or a waterfall dripping over rocks as it dissipates to support a synchronized balance or beautiful formation flow or a clean outfit, but has structural weakness and residues. Sadly, domestic violence is a dark secret.